Prospective follow-up of menstrual disorders in adolescence and prognostic factors.
OBJECTIVE
Clinical follow-up of menstrual status and eating behavior in grown-up women diagnosed with menstrual disturbance in adolescence.


METHODS
Prospective follow-up study six years after the initial study.


METHODS
A youth clinic that is part of the school health system in Stockholm.


METHODS
Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence.


METHODS
Subjects underwent gynecological examination, evaluation of eating behavior and endocrine status.


METHODS
Menstrual status and eating behavior changes.


RESULTS
Menstrual disturbances were still present in 62% of the subjects not using hormonal contraception, 59% of which fulfilled the criteria for polycystic ovary syndrome (PCOS). The frequency of persistent menstrual disturbance was significantly more common in women with previous oligomenorrhea than secondary amenorrhea. The occurrence of eating disorders was decreased by half to 31% in women diagnosed with secondary amenorrhea at the initial study, whereas it was unchanged (40%) in women with previous oligomenorrhea. Recovery from anorectic behavior, primarily in the group of secondary amenorrhea, significantly predicted resumption with menses.


CONCLUSIONS
Menstrual disturbances and eating disorders were still frequent after six years in a follow-up of women who had menstrual disturbance in adolescence. PCOS was the main cause explaining persistent menstrual disorder, whereas recovery of anorectic eating disorders predicted resumption of menses. The findings call for a continued follow-up of women diagnosed with menstrual disturbance in their teens.
Wiksten-Almströmer
Marianne
M
Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden. marianne.wiksten@utbildning.stockholm.se
Hirschberg
Angelica Lindén
AL
Hagenfeldt
Kerstin
K
D000293:Adolescent; D000568:Amenorrhea / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D000856:Anorexia Nervosa / Q000150:complications; D015992:Body Mass Index; D003276:Contraceptives, Oral / Q000008:administration & dosage; D001068:Feeding and Eating Disorders / Q000150:complications*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D009839:Oligomenorrhea / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011379:Prognosis; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood; D013972:Thyrotropin / Q000097:blood
D003276:Contraceptives, Oral; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin